Bill would exempt counties from inmate health-care costs

ANNAPOLIS — Counties would no longer have to pay medical costs for jail inmates with pre-existing conditions, under a bill presented Tuesday before a state Senate panel.

Sen. Christopher B. Shank, R-Washington, said his bill wouldn’t restrict inmates’ access to medical care. Rather, it would protect counties from picking up the tab.

Under the current law, counties are responsible for up to $25,000 of an inmate’s medical expenses. The state reimburses counties for all of the costs greater than $25,000, according to the state Department of Legislative Services.

Under the law, a local correctional facility inmate who is sick, injured or disabled shall “reimburse the county, as appropriate, for the payment of medical expenses.”

In addition, the county may charge an inmate up to $4 per visit to an institutional medical unit or an outside physician, dentist or optometrist, with exceptions.

During a hearing before the Senate Judicial Proceedings Committee, Washington County Sheriff Douglas W. Mullendore said the county spent more than $360,000 in the last fiscal year on care for inmates with pre-existing medical conditions.

That included bypass surgery for an inmate who had a heart condition when he was incarcerated. Mullendore, representing the Maryland Sheriffs Association, said the surgery cost about $160,000. Washington County had to cover the first $25,000 and send two officers to accompany him, he said.

He said pregnancy is another pre-existing condition because the mother requires care. Fourteen female Washington County inmates gave birth in the last fiscal year, Mullendore said. Most didn’t have insurance.

Sen. James Brochin, D-Baltimore County, a committee member, challenged Mullendore’s assertion that a gunshot wound and pneumonia would be pre-existing conditions. Mullendore replied that they require care.

Brochin also wondered why counties wouldn’t sign inmates up for the Maryland Health Insurance Plan, which insures residents with no other coverage.

Mullendore said in an interview afterward that the law currently doesn’t allow inmates to apply for MHIP as indigents, or counties to apply on their behalf.

A legislative services analysis of the bill said it would make inmates responsible for the cost of their care if they have pre-existing conditions.

But Mullendore said the intention was to have the state pay the cost instead of the counties.

He said there might be too much confusion about the intent and wording of the bill, so the committee probably won’t pass it this year. If it fails, he and Shank will work on a better version for next year, Mullendore said.

Shank’s bill also would exempt counties from paying medical costs for inmates with self-inflicted injuries incurred while they’re incarcerated.